FORM J

[See rule 27(1)]

pass for the export of duty-paid imported foreign liquor

PART II - To be handed over to the applicant

No. Dated ...

Name and address of the exporter

Kind of licence of permit held by the exporter and its No.

Quantity and description of duty-paid imported foreign liquor to be exported.

Name and address of the person to whom duty-paid imported foreign liquor is to be exported.

Place to which duty-paid imported foreign liquor is to be exported.

Place from which duty-paid imported foreign liquor is to be exported.

Route (state also the place up to which removal of duty-paid imported foreign liquor will be by road during its transit in the State of Maharashtra).

Period for which this pass shall be valid.

This pass is granted under and subject to the provisions of the Bombay Prohibition Act, 1949, and the rules, regulations and orders made there under and subject to the following conditions, namely:

The whole quantity of duty-paid imported foreign shall be exported in one consignment only and its bulk shall not be broken in transit;
The pass holder shall given an undertaking in writing to abide by the above condition.

Place:

Seal (Signature)

Collector.

(Certificate in Form Certificate-4 to be annexed to paragraph II).

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